A Day in the Life of an Admiral Nurse

Maureen Kanabar is an award-winning Admiral Nurse who works for North East London NHS Foundation Trust (NELFT) in partnership with Dementia UK.

My name is Maureen Kanabar and I am an Admiral Nurse in the London Borough of Havering.

A day in the life of an Admiral Nurse is not easy to describe, as no two days are the same, but every day is very busy!

I work with my Admiral Nurse colleague, Samantha Ponting, and between us we cover the Havering area. Our remit is to support families affected by dementia and improve their quality of life.

We are a point of contact for them if they have any questions or just need someone to talk to. This involves supporting them in all areas of care, educating and signposting when necessary, ensuring they get all the care and services that are available to them locally, encouraging them to take a break and liaising with our colleagues in health care, social services or the voluntary sector, to help them obtain respite care or gain benefit payments etc.

People do not always realise that we are here to support the whole family rather than simply nurse the person with dementia. By working with the whole family, we are able to pass on our expertise to so many more people. They are the ones who are making what are sometimes very difficult decisions about the person they care for while being under great stress themselves.

Families often do not know who to turn to for the right information. As well as often suffering enormous guilt when they feel angry or lonely, they can also feel lost in – and confused by – the system and at these times we are there to help and guide them.

We recently received a telephone call from a very distressed daughter, Hilary*, who cares for her Mum, Gladys*, who is living with dementia. Hilary has always coped very well with Gladys in her own home. However, over a few days Gladys became very unsettled and much more confused and difficult to manage. Hilary felt like she was at the ‘end of her tether’.

As a result of this, the whole home situation was at risk of breaking down. Hilary consulted her GP who arranged for Gladys to be seen at their local hospital.

Gladys was transferred to the Medical Assessment Unit, where she was found to have a Urinary Tract Infection (UTI). Shortly afterwards, Hilary was told that her Mum was now medically fit for discharge. Hilary telephoned the Admiral Nurse Service, as she did not feel able to state why she felt her mum should not be discharged.

Hilary was exhausted, as is often the case when there is an infection, which can also significantly exaggerate the symptoms of dementia. I telephoned the ward and spoke to a staff nurse and voiced my concern that Gladys was being discharged to a home environment that was at risk of breaking down due to Hilary’s fatigue and sense of increased carer burden.

Family carers can feel less isolated if they have someone to turn to

I clarified that Hilary wanted her mum home once her infection had been successfully treated and the UTI was clear. The staff nurse then liaised with the medical team who decided to admit Gladys. If Hilary had not had someone to turn to and advocate for her and her mum; someone who could liaise with the staff, her mum’s discharge from hospital may have increased Hilary’s carer burden and potentially put them all at risk.

Some of the most distressing times for family carers are when the person they are looking after becomes uncooperative, no longer recognises them or, worse, in the case of a son or daughter, misinterprets them for their own husband or wife. These are the times when the carer needs to ‘air’ their feelings and this can help to relieve their perceived carer burden. Family carers can feel less isolated if they have someone to turn to and are able to normalise what is happening as a common symptom of dementia.

The primary family carer can often be very protective of the rest of their family and may not wish to overburden them. Having an Admiral Nurse to talk to, and who approaches each family member’s needs individually, can make all the difference to their ability to carry on and retain a sense of family life.

Knowing we are helping is the best thing about being an Admiral Nurse. Admiral Nurses witness first hand examples of great love and devotion and it is an honour to work alongside our families.

We also run an informal monthly support group where family carers can discuss anything they want. This gives carers the opportunity to meet other carers and gain extra knowledge and support from people in a similar situation. We invite them along to have a cup of tea and a biscuit (or two) and they are welcome to stay for as long as they like – whether it’s 10 minutes or the whole session. Great friendships have been formed within the group. We always welcome any new family carers.

Together with the Alzheimer’s Society, we run an Alzheimer Café on a monthly basis. This also brings families together and provides opportunities to socialise and have some fun. We have a quiz and a raffle and a guest speaker to educate and inform them on a variety of subjects relating to dementia. They have lunch together in a relaxed atmosphere and for many of our families it is a lifeline in what can sometimes feel like troubled times.

The family carers we work with are very appreciative. I was recently nominated by three of our family carers for the Great British Care Awards in the Dementia Care category. The awards night was very exciting and I was amazed and delighted to win this award for the Greater London Area for 2012. I am very grateful for the award, but I think it is the families I work with who really deserve an award. 

* Gladys and Hilary are pseudonyms


For more information on Admiral Nurses, visit www.dementiauk.org or call 0845 257 9406